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Review
. 2022 Aug 4:16:1919-1939.
doi: 10.2147/PPA.S367046. eCollection 2022.

Treatment-Related Attributes of Diabetes Therapies and How People with Type 2 Diabetes Report Their Impact on Indicators of Medication-Taking Behaviors

Tracy J Sims  1 , Kristina S Boye  1 , Susan Robinson  2 , Tessa Kennedy-Martin  2
Affiliations
Review

Treatment-Related Attributes of Diabetes Therapies and How People with Type 2 Diabetes Report Their Impact on Indicators of Medication-Taking Behaviors

Tracy J Sims et al. Patient Prefer Adherence. .

Abstract

Purpose: Understanding the treatment-related attributes influencing medication-taking behaviors in people with type 2 diabetes (T2D) is important for delivery of patient-centered care. This review aimed to identify and summarize studies in which people with T2D (PwD) directly indicated the treatment-related attributes associated with medication-taking behaviors or intentions.

Materials and methods: EMBASE and PubMed were searched for studies (Jan 2005-May 2021) reporting the link between PwD-expressed diabetes treatment-related attributes and the decision to initiate, adhere to, or discontinue a T2D medication. Eligible studies reported attributes associated with oral antidiabetes drugs or injectables (not insulin). Studies not explicitly exploring the link between attributes and indicators of behaviors (eg most discrete-choice experiments [DCE] and those interrogating electronic medical records or claims databases) were excluded, as were studies where the link between attribute and behavior came from anyone but the PwD.

Results: Of the 6464 studies identified, 16 were included. Studies were conducted across multiple countries; the USA was most represented (n = 8 studies). The impact of treatment attributes was described on indicators of initiation (n = 3), adherence (n = 12), and discontinuation (n = 4). Some studies evaluated multiple behaviors. PwD perspectives were solicited by structured questionnaires (n = 10), qualitative approaches (n = 4), or DCE explicitly exploring the link to medication-taking behaviors (n = 2). Closed- (n = 9) and open-ended questions (n = 7) were employed. Across studies, several factors including glycemic efficacy (n = 9), weight change (n = 9), dosing frequency (n = 9), hypoglycemia (n = 8), gastrointestinal adverse events (n = 8), regimen complexity (n = 6), route of administration (n = 3), and cardiovascular risk (n = 1) were reported as influencing behaviors, being motivators or barriers to initiation, adherence, or discontinuation.

Conclusion: Several attributes influence how PwD take their medications. Insights gained directly from PwD have the potential to assist stakeholders in making more informed, patient-centered, treatment decisions, thus choosing and managing medications that PwD are comfortable initiating and persisting with over the longer term.

Keywords: adherence; discontinuation; medication attributes; type 2 diabetes.

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Conflict of interest statement

Tracy J Sims and Kristina S Boye are employees and minor shareholders of Eli Lilly and Company. Dr Susan Robinson reports grants from Eli Lilly and Company, during the conduct of the study. Tessa Kennedy-Martin and Susan Robinson are employees of KMHO, who received funding from Eli Lilly for time spent conducting this research and fees for other project work undertaken for Lilly outside the submitted work. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study selection.
See this image and copyright information in PMC

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